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How to Streamline Cross Continuum
Data for Greater Usability
Session #98, February 13, 2019
Dan Paoletti, CEO, Ohio Health Information Partnership (The Partnership)
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Dan Paoletti
Has no real or apparent conflicts of interest to report.
Conflict of Interest
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Learning Objectives
Agenda
What is The Partnership?
The Problems: Acknowledge Drivers for Change
The Partnership Approach to Greater Usability of Data
Benefits of HIE Data
Measuring Success
Next Steps for The Partnership
How You can Get Started
Questions
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List key benefits of streamlining HIE data
Describe essential information to include in a comprehensive clinical care
document (CCD)
Explain how to integrate access to information into existing physician
workflow, detailing best practice strategies
Discuss how to use HIE clinical information to drive population health
efforts, including quality reporting and improving care management for
high-risk patients
Describe methods for incorporating clinical advisory group feedback into a
technology initiative, leveraging all viewpoints to meet strategic goals
Learning Objectives
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Dan Paoletti
CEO, The Partnership
Your Speaker
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What is The Partnership?
157 hospitals
More than 900 physician practices
Stores information on 13 million
patients with 3 to 4 million new pieces
of data each day
Nonprofit entity assisting Ohio physicians and other providers with health
IT adoption and implementation
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Acknowledge Drivers for Change
Volume and
duplication of
information to
providers was
staggering
One patient query
could generate:
• 10+ unique CCDs
• Translates into
100s of pages of
information
Providers did not
have the time
necessary to wade
through the data and
were not using it
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A seamless
plan for
moving
forward
Streamline information and seamlessly embed
it into existing provider workflow
Support improved and cost-effective care plans
Make data as simple as possible to use
Reduce duplicative care
Avoid missed care opportunities
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Key to Success:
Garner Stakeholder Input
Clinical
Advisory
Group
Hospitals
Physician practices
Health systems
Home health facilities
Pharmacies
Payers
Behavioral health
organizations
Provide valuable guidance in how to consolidate
information and weave it into existing workflow
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How is most data exchanged from outside your organization?
1. Regional or state HIE
2. eHealth Exchange
3. Carequality or CommonWell
4. We don’t participate in HIE
Polling Question # 1
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• Need to prioritize the types of data included on the CCD
• Deliver what physicians need to inform care delivery in a way that is
not overwhelming
• Started with standard CCD template:
– Medical history
– Problems, medications and allergies
– Lab results
– Imaging and other reports
– Physician notes
– Care summaries and orders
Identify Pain Points in Current
Data Process
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Determine Critical Data Needs
Data itself was in a good place;
however, there were significant
problem areas
Duplication
Lack of normalization
Quantity of information
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Consolidating Data for Quick Review
CCD Single
comprehensive
record
Community Interchange
Goal: Create an end product that was a single, comprehensive CCD that
is easy to review and understand
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Reimagining the Format
• Normalize data to help with information
consistency
• Tune de-duplication algorithms to
eliminate redundancies
• Design settings so that queries would
not receive a match if only
demographic data was available
• Reorganize the CCD so information is
presented in chronological order for
easy navigation
• Sort data to follow a more logical
clinical flow
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What is your main driver to engage in information exchange?
1. Inform clinical care
2. Help with quality reporting
3. Manage population health
4. I am not a part of an HIE
Polling Question #2
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For many organizations, the EHR automatically queries each night for data
on the next day’s patients
Weave Data into Provider Workflow
ER
New data is delivered
90 minutes before
patients’ scheduled
appointments for provider
review
Provider receives
notification in the patient’s
record that a document is
available for download
into the EHR
Allows for on-the-fly
queries for non-scheduled
patients that arrive at the
emergency department or
urgent care
90
mins
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• Organizations with non-
integrated technology:
– Sign into the
CliniSync web portal
and search for the
patient
– Download
consolidated CCD
into EHR
• Direct messaging between
providers to communicate
critical information
Weave Data into Provider Workflow
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 Get a more complete picture of a patient’s health and the
interventions he or she has received
 Allows providers to quickly see what’s happening outside
organization walls
 Provides clinical data organizations didn’t have in the past
 Reduces care duplication and enables more focused testing
 Yields better quality care
 Reduces costs
Benefits of HIE Data:
Better Care Management
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• Data available in an analytical database supports quality measure
reporting and population health
• System reports on 28 measures for 5 chronic conditions:
– Heart disease
– Diabetes
– Back pain
– Pre/post-natal care
– Preventive care
• Zero in on the most resource-intensive cases
Benefits of HIE Data:
Population Health
Benefits of HIE Data:
Population Health
Uncover trends with analytics-ready dataUncover trends with analytics-ready data
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Benefits of HIE Data:
Population Health
Ohio organizations
are taking on more
risk in their
reimbursement
models
Transforming from the
use of claims data to
near real time clinical
data to better manage
risk
Upcoming:
Analytics-ready
reports guide
decision making for
those patients
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Measuring Success
Total number of
results delivered
per month:
>1M
Total number of
practices
delivered to:
2,680
Total number of
providers
delivered to:
4,084
Number of queries
to the web portal
per month:
>1M
Number of
patient searches
via the web
portal per month:
>400K
Number of
integrated EMR
queries into the
Community
Health Record
per month:
>1.5M
Number of
notifications sent
out per month:
>500K
Total number of
health plans
participating:
8
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Measuring Success
50%
Even among health systems
that use a large integrated EHR,
on average 50% of their patients
have data that sits outside of
the network
Out of 14 million patients registered in our system, the vast majority of
them have visited providers outside of their network
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Next Steps: The Work Continues
Ongoing
refinement of
information
sent to
hospitals and
physicians
Quarterly
meetings with
the 32-member
clinical advisory
group
Statewide
workgroup to
delve further
into data
usability
Addition of
claims and
social
determinants
of health
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Next Steps: The Work Continues
Beyond adding hospitals
and physician practices
to our system, we are
expanding to other
unique groups
Behavioral health,
home health,
long-term care facilities
Pharmacies
Social service agencies
Community organizations
EMS organizations
Our payer-provider workgroup is focused on building trust and
establishing ways for bidirectional information exchange
Health plans
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• Department of Defense — Sequoia
Project
– Wright-Patterson Air Force
Base
• Department of Veterans’ Affairs
• Other state HIEs
• Large healthcare organizations
across the country
Next Steps: Building Relationships
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Lessons Learned:
What You Should Know
Should be viewed
as more than solely
a technology project
Stakeholder
champions are critical
to success
Bring in different
groups together to
guide the project
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How you
can get
started
• Identify key stakeholders and pull together an
advisory team
• Embrace a collaborative mindset
• Focus on data quality and completeness
• Acknowledge the idea that more information
is not always better
• Concentrate on identifying the right information
and getting it into the hands of the right person
at the right time
